Work performance and its clinical correlates in patients with chronic mental illness: The Chinese version of Vocational Cognitive Rating Scale and the work behavior inventory.

Abstract

Objective: Occupational function assessment is essential for rehabilitation of severe mental illness but lacks comprehensive tools. Method: This study examines the psychometric properties of the Chinese versions of the Vocational Cognitive Rating Scale (VCRS) and the Work Behavior Inventory (WBI) in 60 chronic patients from a psychiatric daycare center and identifies clinical correlates of occupational function measured on the Positive and Negative Syndrome Scale (PANSS). Results: The Chinese VCRS and WBI showed adequate internal consistency, interrater and test-retest reliability, and good convergent validity with the Comprehensive Occupational Therapy Evaluation Scale. Factor analysis favored a one-factor solution of the VCRS; and a four-factor structure in the WBI including Efficiency, Social Interaction, Appropriateness, and Regularity. The VCRS and Efficiency were predicted by fewer disorganization but greater affective symptoms. Social Interaction was negatively predicted by resistance symptoms. Appropriateness was associated with all but negative symptoms. Regularity was predicted by fewer negative symptoms. Considering work behavior altogether, WBI total scores were predicted by fewer negative, fewer disorganization, and greater affective symptoms. Conclusions and Implication for Practice: Findings suggest that the Chinese VCRS and WBI have sound psychometric properties and are suitable for both clinical trials and for planning personalized rehabilitation programs. Impact and ImplicationsThis study provided the first validation of the Vocational Cognitive Rating Scale and the Work Behavior Inventory-two functional assessment tools regarding work performance specific to patients with mental illness-in an Asian country. We derived a new factor structure for finding unique relationships between clinical profiles and each facet of various work behaviors. The findings provide evidence to support a more delicate assessment of occupational function while providing a fundamental foundation for developing future personalized rehabilitation programs.